Peripheral Neuropathy: How it Impacts the Quality of Life
Peripheral neuropathy is a condition that affects the nerves outside the brain and spinal cord. As is evident from the name, peripheral relates to anything outside – the brain and the spinal cord (the central nervous system), while neuropathy is a disease affecting the nerves. As a result, the nerves that act as messengers carrying messages to and from the brain and spinal cord to the rest of the body are damaged. Due to this interruption in the communication that is critical for body mobility, muscle movement can become impaired, affecting movement in the limbs and also causing pain.
Considering the loss of movement and pain that an individual with this condition experiences, several issues can arise that drastically impact the individual’s quality of life. This could include loss of balance, change and imbalance in gait, stabbing or burning pain in the limbs, a higher risk of falls, etc., due to the nerve damage affecting the motor and sensory nerves.
Peripheral neuropathy can manifest as mononeuropathy where only one nerve is affected or as polyneuropathy where multiple nerves are affected. While the former is uncommon, the latter is more common with carpal tunnel syndrome being one example.
Common Causes of Peripheral Neuropathy
Diabetes is among the most common causes of peripheral neuropathy resulting in extensive nerve damage. Beyond this however, there can be several other causes. These could include injuries, predispositions, hereditary causes, etc.
Common causes of peripheral neuropathy include:
- Diabetes – Approximately 50% of people with diabetes are vulnerable to developing some form of neuropathy[1].
- Autoimmune diseases – Diseases such as Guillain-Barre syndrome, vasculitis, lupus, rheumatoid arthritis, Sjogren’s syndrome, and chronic inflammatory demyelinating polyneuropathy can result in peripheral neuropathy.
- Inherited conditions – Conditions such as Charcot-Marie-Tooth disease are hereditary and known to result in specific types of neuropathies.
- Viral/Bacterial infections – Infections such as leprosy, HIV, shingles, Epstein-Barr virus, and more also increase the individual’s susceptibility to neuropathies.
- Benign and malignant growths – Any growths or tumors that press against the nerves or reduce the body’s immune response can also be a cause of peripheral neuropathy.
Other diseases and disorders that can cause peripheral neuropathy include hypothyroidism, liver disease, kidney disease, lymphoma, etc.
Beyond diseases and disorders, there are other causes of the condition as well. These include the following:
- Specific medications such as those used to treat cancer
- Vitamin deficiencies
- Excessive consumption of alcohol
- Exposure to toxic substances
- Injuries causing pressure on the nerves
In rare cases, despite extensive evaluation and examination, the cause may not be evident. Such neuropathies are classified as idiopathic neuropathy.
Common Symptoms of Peripheral Neuropathy
The nerves in the human body are classified into three different subheads depending on their specific set of functions. They are as follows:
- Autonomic nerves – Functions such as bladder movement and control, heart rate, digestive abilities, and blood pressure are under the control of the autonomic nerves
- Sensory nerves – The body’s ability to sense or feel, pain, touch, heat or cold, etc., are controlled through the sensory nerves
- Motor nerves – These nerves control the movement of muscle
The manifestation of the symptoms of peripheral neuropathy is dependent on which of the nerves have been affected.
If the motor nerves are affected, the following are some of the symptoms that you are likely to experience:
- Muscle weakness
- Lack of balance
- Sharp, jabbing, throbbing or burning pain
- Muscle cramps
- Lack of coordination
- Pain during normal day to day activities
- Twitching sensations
- Sudden falls
- Paralysis in extreme cases
When sensory nerves are affected, you may experience the following:
- Sudden or gradual onset of sensations of tingling and numbness that may travel along the limbs
- Reduced sensations
- Sensation or feeling of wearing clothes such as socks or gloves, even when you are not
- Extreme sensitivity to touch
When autonomic nerves are affected, you may experience symptoms such as:
- Low blood pressure
- Problems and control of bladder and/or bowel movements
- Excessive perspiration
- Digestive issues
- Intolerance to heat
- Constipation
Complications Associated with Peripheral Neuropathy
Peripheral neuropathy, when left untreated, can cause serious complications. Some most commonly occurring include:
- Diabetic foot ulcers
- Gangrene
- Blood circulation issues
- Increased incidence of falls
- Increased chances of burns and skin injuries due to reduced sensation in the skin
- Increased infections as a result of low skin sensitivity
- Severe digestive disorders
- Complete loss of bowel/bladder control
- Heart conditions
Early diagnosis and treatment can not only help prevent most of these complications, it can also stop the progression of the peripheral nerve damage.
Treatments Options for Peripheral Neuropathy at Advanced Pain Care
To identify the potential causes of peripheral neuropathy, the specialists at Advanced Pain Care will complete a comprehensive examination that will include the following:
- Physical examination
- Review of family and previous health history
- Review of current lifestyle
- Neurological examination
Tests are also likely to be ordered such as:
- Blood tests to detect diabetes, vitamin deficiencies, immune system function, etc.
- Imaging tests to detect tumors, nerve compressions, herniated discs, etc.
- Nerve function test to detect the extent of the nerve damage
- Biopsies of the skin and/or nerves
- Other tests such as sweat test, sensory test, and more
The treatment options at Advanced Pain Care include the following:
- Medications – The specialists at Advanced Pain Care may begin treatment with medications. These can include pain-relieving drugs such as non-steroidal anti-inflammatory drugs or opioids depending on the intensity of the pain. It can also include anti-seizure and antidepressant medicines, as well as topical applications in case of skin sensitivity issues.
- Physical therapy – This is helpful in the case of motor nerve-related issues that affect posture, balance, and gait.
- Therapies – The specialists at Advanced Pain Care facilitate different treatment therapies that include spinal cord stimulation, Transcutaneous Electrical Nerve Stimulation (TENS), plasma exchange, nerve blocks, and more.
In rare cases, and where required, the specialist may consider surgery as an option. Nerve decompression surgery is most commonly performed, primarily to relieve pressure on the nerves.
Other surgical interventions include the following:
- Thermocoagulation
- Microvascular decompression
- Stereotactic surgery
- Peripheral neurolysis
- Neural augmentative surgeries to stimulate the affected nerves
- Balloon decompression
- Gamma-knife radiosurgery
- Nerve ablation
- Intrathecal pumps for drug delivery
- Plasmapheresis
- Neuromodulators
- Deep brain stimulation
- Motor cortex stimulation
If you have been experiencing nerve pain, or are experiencing any of the signs and symptoms listed above, relief is available at Advanced Pain Care. Visit us online or call 512-244-4272 to schedule a same or next-day appointment with a neurosurgeon or pain management doctor.
At Advanced Pain Care, we accept insurance coverage from different network carriers. Click here to check if your insurance provider is listed. We also have a patient portal to facilitate easy access to all our facilities including prescriptions and bill pay. Additionally, you can refill a prescription or request records online should you need them.
We have several centers serving Austin, Amarillo, and Waco/Killeen as well as advanced surgery centers in Round Rock, Austin, and Amarillo. You can contact us on our mainline or check our website for center-specific contact details.
References
[1] https://www.uptodate.com/contents/epidemiology-and-classification-of-diabetic-neuropathy
Mark T. Malone, M.D., is a Board Certified pain specialist and a native Texan. He received his undergraduate degree from the University of Texas at Austin, and went on to attend the University of Texas Southwestern Medical School. Dr. Malone attended Baylor College of Medicine… View Profile
